Is there a change in the incidence and prevalence of inflammatory bowel diseases in eastern Europe?

Limited data are available on the epidemiology of IBD in East European countries. According to the initial studies the incidence and prevalence of IBD were much lower compared to Western Europe. The aim of the study was to summarize the available data on the frequency of IBD in this region.

Methods: The authors performed a detailed MEDLINE and EMBASE search and identified all available studies on the epidemiology of IBD in East Europe. Additionally, some experts from these countries were personally contacted.

Results: Most of the studies were retrospective or hospital based case-series from secondary and tertiary centers. In some countries the data were collected by self reported questionnaires with rather low incidence rates; in the Czech Republic the incidence of UC increased from 1.4/100 000 (1967), to 3.1 (beginning of 1990s). In North-East Poland between 1990 and 2003 the incidence of UC was 1.8 that of CD was 0.1. In Romania according to a nationwide survey in 2002 the incidence of UC and CD were 0.97 and 0.50. Similarly, the incidence of UC and CD in Baltic countries in Tartu, Estonia between 1993 and1998 was 1.7 and 1.4. In contrast, in Hungary and Croatia more detailed, population-based data are available. In Zagreb, Croatia between 1980 and 1989 the incidence of UC was 1.5 that of CD was 0.7. Much higher incidence was recorded in a prospective survey at the Adriatic costal area between 2000 and 2004 (UC: 4.3, CD: 7.0). A recent study from Hungary reported also an increase in incidence rates for UC (from 1.6 to 11.0) and CD (from 0.4 to 4.7) between 1977 and 2001, comparable to that in Western Europe.

Conclusion: After the disappearance of the north-south gradient, recent data support an additional change also in the west-east gradient. A partial explanation can be found in changes of the socioeconomic or environmental (e.g. diet, lifestyle) backgrounds. It is therefore, of great interest to further investigate and monitor the temporal trends of IBD in East Europe.